Department of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
J Thromb Haemost. 2010 Feb;8(2):221-7. doi: 10.1111/j.1538-7836.2009.03690.x. Epub 2009 Nov 13.
Malignant gliomas are associated with a very high risk of venous thromboembolism (VTE). While many clinical risk factors have previously been described in brain tumor patients, the risk of VTE associated with newer anti-angiogenic therapies such as bevacizumab in these patients remains unclear. When VTE occurs in this patient population, concern regarding the potential for intracranial hemorrhage complicates management decisions regarding anticoagulation, and these patients have a worse prognosis than their VTE-free counterparts. Risk stratification models identifying patients at high risk of developing VTE along with predictive plasma biomarkers may guide the selection of eligible patients for primary prevention with pharmacologic thromboprophylaxis. Recent studies exploring disordered coagulation, such as increased expression of tissue factor (TF), and tumorigenic molecular signaling may help to explain the increased risk of VTE in patients with malignant gliomas.
恶性脑胶质瘤与静脉血栓栓塞症（VTE）的风险非常高有关。虽然之前已经在脑肿瘤患者中描述了许多临床危险因素，但在这些患者中，贝伐珠单抗等新型抗血管生成治疗与 VTE 相关的风险仍不清楚。当 VTE 发生在这些患者人群中时，由于担心颅内出血，抗凝治疗的管理决策变得复杂，并且这些患者的预后比没有 VTE 的患者更差。识别有发生 VTE 高风险的患者的风险分层模型以及预测性血浆生物标志物可能有助于指导有资格的患者选择药物预防血栓形成。最近的研究探索了紊乱的凝血，如组织因子（TF）表达增加和致瘤分子信号，可能有助于解释恶性脑胶质瘤患者 VTE 风险增加的原因。
